Falmouth High School is experiencing a pertussis outbreak – with four confirmed cases in the past two weeks – while the Maine Legislature debates whether to tighten vaccination requirements for attending school.

Maine has the worst pertussis rate in the nation, with cases so far this year tracking ahead of 2018’s numbers.

Since January, pertussis outbreaks have also occurred in York and Lincoln county schools, according to the Maine Center for Disease Control and Prevention.

Matt Hogenauer, a Falmouth High School senior who is immune-compromised because he has non-rheumatoid arthritis, said he contracted pertussis two weeks ago, although it was a mild strain and he recovered quickly. Hogenauer said he could have been out of school for weeks or hospitalized had he been infected with a worse strain.

“It’s very real for me. Luckily, I didn’t get that sick from it,” Hogenauer said. He said he’s upset at the prevalence of the anti-vaccination movement. “It’s disappointing that not only are people unwilling to acknowledge reputable science behind the debate, but they are willing to ignore the right now, that the CDC is saying this is causing outbreaks right in our backyards.”

Maine had 95 pertussis cases through February, and 446 cases in 2018. Last year’s pertussis numbers were the worst since 2014, and the 95 cases so far this year are more than double the 40 cases through the first two months of 2018.

Maine’s pertussis rate was 27.7 per 100,000 people in 2017, the most recent figures available for national comparison, according to the federal Centers for Disease Control and Prevention. That’s the highest rate in the nation and more than six times the national average of 4.13 cases per 100,000.

The worst year for pertussis in the past decade was 2012, when Maine had 737 cases.

Pertussis is a bacterial infection that produces a violent cough that can trigger vomiting and exhaustion. Babies too young to be vaccinated and the elderly are especially vulnerable to serious cases, which may require hospitalization and can lead to death. The cough can linger for up to 10 weeks and is treated with antibiotics.

Dr. Anne Coates, a pediatric lung specialist at Barbara Bush Children’s Hospital in Portland, said pertussis is not a benign disease and should be taken seriously. Coates cared for a 2-week-old infant who died several years ago when she was working at Lucille Packard Children’s Hospital at Stanford University in California.

“It was crushing,” Coates said. “So many things in life are out of our control, but preventing these diseases is within our control with vaccination, and the downside can be death,” Coates said.

Coates said there are likely “multiple factors” that cause Maine’s pertussis rates to be so high, but it’s “indisputable” that one of them is low immunization rates.

The pertussis vaccine’s effectiveness wanes over time, which is why pediatricians recommend a booster shot in middle school. Maine now requires the booster for incoming seventh-graders.

“Maine was one of the last states to implement a 7th grade (tetanus, diphtheria and pertussis) booster, which went into effect during the 2017-18 school year,” said Emily Spencer, Maine CDC spokeswoman. “We’re hopeful that this will begin to reduce the number of pertussis cases in Maine by providing increased protection among this 7th grade age group that has historically experienced higher rates of the disease. It’s too early to tell how the law is affecting pertussis rates, but we continue to track this information for analysis.”

Meanwhile, the Legislature is considering whether to eliminate the philosophical and religious exemptions for vaccinations required to attend school, in light of Maine’s high levels of pertussis, as well as measles outbreaks in Washington state and New York City among unvaccinated populations.

A public hearing in Augusta this week attracted hundreds of people, including public health experts and anti-vaccination advocates. Many who spoke against the proposal to eliminate exemptions repeated untrue claims that vaccines are linked to autism or are likely to injure patients.

Vaccines do not cause autism, according to overwhelming scientific evidence and research, and a single 1998 scholarly article that claimed a link between vaccines and autism has been debunked and retracted. It is possible, but extremely unlikely, that a patient could have a severe reaction to a vaccine. For instance, severe allergic reactions to the measles vaccine are estimated to occur three or four times for every 10 million doses given, according to the American Academy of Pediatrics.

Prior to the measles vaccine becoming widely available in the 1960s, 3 to 4 million people in the United States were infected with measles each year, causing nearly 50,000 hospitalizations annually. About 1,000 measles patients contracted encephalitis and there were 400 to 500 deaths annually from measles, according to the federal CDC.

If Maine’s bill, sponsored by Rep. Ryan Tipping, D-Orono, and Sen. Linda Sanborn, D-Gorham, is approved, the state would join California, West Virginia and Mississippi among the handful of states that have eliminated all non-medical exemptions for school-required vaccinations for pertussis, measles, chicken pox and other diseases. The Maine CDC supports the bill.

Rep. Richard Farnsworth, D-Portland, is on the education committee, which heard several hours of testimony on the vaccination bill. Farnsworth, 78, said he supports Tipping’s bill, and while he’s sympathetic toward people who believe they’ve been harmed by vaccines, he remembers when most vaccines weren’t available and people suffered from the diseases.

“I remember kids who had polio in the iron lungs,” Farnsworth said. “There was an outbreak of rubella in the 1960s, and many women who were pregnant at the time gave birth to children who were born deaf and blind.”

Farnsworth said his brother contracted measles, and while he recovered, they had to mark their front door in red so people knew to stay away. Farnsworth lined up with all of his fellow high school students in the mid-1950s to get the first-ever polio vaccine.

“Nobody, I mean, nobody refused the vaccine,” Farnsworth said. “Everyone understood the risk of these diseases.”

Joe Lawlor can be contacted at 791-6376 or at:

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